Re: Subject: Section on demand
From: ainsron (ainsron@sbcglobal.net)
Wed Apr 26 08:39:13 2006
Section her. My wife had a fourth degree and rectoperineal fistula after
our first son was born, following a forceps delivery for a transverse
arrest. I was a medical student at the time. Looking back through the
retrospectoscope, I would have sectioned her. Our last four were born by
C/S, great recoveries and no second thoughts.
Ronald E. Ainsworth, MD, FACOG
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E.
Siegel, M.D.
Sent: Tuesday, April 25, 2006 7:19 PM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Subject: Section on demand
A well-thought out and most excellent post, Mona.
I would section her after the due dilligence all have mentioned.
So. . .today I saw a 34 YO P1001 with infertility who had failed IUI
and was heading to IVF when, lo and behold, while doing that which the
neighbors do, conceived. All is well at 6.5 weeks. I attended her
first delivery, a low forceps with rotation (OP to OA, +2 with Dr.
Keilland's instruments) 4 years ago, and she had a 4th degree laceration
which has healed nicely with no obvious sequelae. In passing, she
mentioned having a section this time. We discussed this for literally a
moment, and I said "Let's get out of the first trimester and we can
decide later, but I'm not saying no."
What say my wise friends and colleagues?
Garry
PS--agree with easy recovery for PLANNED section in many people!
At Tue, 25 Apr 2006, Seele, Mona wrote:
>
>A lot of women who have had both a vag delivery agree with both of
>you...it is very much related to each individual's experience.
>
>I have taken care of patients who had both kinds of delivery and with
>the vag delivery had a tear,epis or labial hematoma that they thought
>was just as/or more painful as the incision. With good pain mangement
>following c/s some mothers think it is the better experience. And those
>that experienced a long, difficult labor who ended up with a c/s often
>do not want to go through that again.
>
>One of the reasons that ACOG and the NIH took the stand that a mother
>should be able to have a c/s on her preference is because historical
>data on c/s and vaginal deliveries has shown no statistical difference
>in safety for the patient or baby if they do not want a big family.
>Some very educated mothers like the ability to schedule their delivery
>and then, knowing they will have a repeat, plan on getting a tubal since
>their family is complete.
>
>The patient has been given the right to choose and we should educate
>them to the risks and advantages of both vaginal delivery and c/s,
>document this well, and then honor their wishes.
>
>This argument has been discussed over and over and over on this list and
>there will never be agreement on all points. I, for one would rather
>drop this issue and go on to more interesting and informative issues.
>
>Mona Seele, RN, MSN, CNS
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Jamie
>Sent: Tuesday, April 25, 2006 8:03 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Subject: Section on demand
>
>A lot of women who have had both disagree.
>
>At Tue, 25 Apr 2006, Richard Chudacoff, MD wrote:
>>
>>True...but I disagree that c-section recovery is significantly worse
>>that vaginal delivery. Especially an elective c-section
>>
>>--
>>Richard Chudacoff, MD, FACOG
>>
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Dr
>>Eberhard Lisse
>
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Re: Subject: Section on demand
>>
>>Richard,
>>
>>of course it is hard to recover from a delivery, and it is hard to take
>
>>care of a new baby, especially if she is single.
>>
>>But she should have thought about this 35 weeks ago, because this goes
>>for all modes of delivery.
>>
>>:-)-O
>>
>>el
>>
>>on 4/25/06 3:09 PM Richard Chudacoff, MD said the following:
>>> This I do not agree with.
>>>
>>> Richard Chudacoff, MD, FACOG
>>>
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>>> *From:* ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] *On Behalf Of
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>>> *Stmidwife@aol.com
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>>> *Sent:* Monday, April 24, 2006 9:04 PM
>>> ---------------------------------------------------------------------
>>> *To:* Multiple recipients of list OB-GYN-L
>>> *Subject:* Subject: Section on demand
>>>
>>> I'd also explain how hard it is to recover and take care of a new
>>> baby.(especially if she is single which I don't know if she is or
>not).
>>>
>--
>JFields, RN, BSN
>
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--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA
